New guidance has been published by NHS England and NHS Improvement on pulse oximetry to detect early deterioration of patients with COVID-19 in primary and community care settings.
The document sets out principles to support the remote monitoring, using pulse oximetry, of patients with confirmed or possible COVID-19.
Patients most at risk of poor outcomes can be identifued using oximetry to monitor and identify ‘silent hypoxia’ and rapid patient deterioration.
This guidance standardises the assessment, monitoring and safety netting that aligns the acute care of suspected COVID-19 patients in primary and secondary care settings, and links with a virtual ward model. This will comprise of 2 distinct but interlinked phases:
- Phase 1: The adult primary care assessment of suspected COVID-19 patients: Without national guidance, local systems have had to develop their own pathways, leading to non-standardisation and misalignment with ambulance and hospital trusts.
- Phase 2: The COVID-19 virtual ward model: This includes the safety netting, monitoring and review of suspected COVID-19 patients in community settings, populated by patients who are either identified by GPs or discharged by hospitals.
The national guidance was produced collaboratively, led by Dr Matt Inada-Kim (National Deterioration Clinical Lead NHS England and NHS Improvement, and Wessex AHSN Clinical Lead), with input from senior GPs and alignment with NHS 111 and NHS guidance for emergency admissions.
Eight small pilots (wave 2) and three large population-based pilots (wave 1) are underway. The wave 2 pilots are being supported by the Patient Safety Collaboratives (PSCs) as part of the National Patient Safety Improvement Programme’s Managing Deterioration workstream.
PSCs have been making contact with the pilots, offering quality improvement support and inviting them to join the NHS @Home Pulse Oximetry Learning Network, which aims to share learning and support the ongoing programme of care. All pilots (both waves 1 and 2) will submit data as part of a national evaluation to inform future pathways of care.
Follow this link for more information on patient safety during COVID-19.